This sample form may be used to submit a complaint (also known as a
request for an impartial hearing)
to resolve a disagreement about the referral, evaluation or placement of a
student or regarding the provision of a free appropriate public education for a
student
under the Individuals with Disabilities Education Act.

Party Submitting the Complaint Notice

Requests for a due process hearing must be made in writing.

All
asterisked (*) information on this form must be included when you
submit a Due Process Complaint Notice to request an impartial hearing.

If
you, or your attorney, do not include the asterisked(*)
items on this form, it may result in the denial or delay of a resolution
session and/or a
due
process hearing and the reduction of any attorney’s fees awarded by a
court.

You may request
mediation, at any time,
including prior to filing a due process complaint notice.

If you
are a parent requesting a due process hearing, unless you and the school
agree otherwise to
proceed with mediation or begin the impartial hearing, you will be
required to meet with the school within 15 days after the school has
received the notice to try to resolve the problem before a due process
hearing may begin.
This is called a resolution session.

Party Receiving This Notice

If you
believe the notice is not sufficient (does not fully provide the required
asterisked information), you may notify the
appointed impartial hearing officer and the other party in writing within
15 days of receipt of this notice.

The
impartial hearing officer must decide if the notice is sufficient within
five days of the sufficiency request and notify both parties in writing.

The
timelines to resolve the due process complaint do not begin until the notice
is complete.

Within
10 days of receiving a due process hearing complaint notice, you must
send to the other party a response that specifically addresses the issues
raised in the request.

If
the school has not sent prior written notice to the parent regarding the
subject matter contained in the parents’ due process complaint notice,
the school must send a response to the parent within 10 days of receiving
the due process complaint notice in accordance with section
1415(c)(2)(B)(i)(I)
of the Individuals with Disabilities Education Act.